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Health Insurance Law for Farmers an

Health Insurance Law for Farmers and Agriculture Workers
On the occasion of Farmer’s Day, 9 September 2014, Presidential Decree-Law 127 of 2014 was issued regulating the health insurance for farmers and agriculture workers (the "Law"),[1] whereby the State will provide health insurance for agriculture workers and farmers who do not have any insurance under any other decree. The Law has defined ‘farmer’ as "any person engaged in the activity of agriculture and for whom agriculture represents the main source of income". The term ‘agriculture worker’ was not defined.
Funding the Insurance
Article 4 of the Law addresses the ways in which the new insurance system will be financed; these include annual subscriptions paid by the beneficiary of the insurance up to a maximum of EGP 120 per annum, an annual subscription borne by the public purse of EGP 200, a Ministry of Agriculture contribution in the amount of 2% of charges for services provided by the Ministry, as well as the financial support provided by agriculture entities and other grants and donations provided by other associations. The financing proceeds will be deposited in a special account with the General Authority for Health Insurance, to be supervised by the Central Accounting Agency and actuarially evaluated once every three years. The Law obliges the State Treasury to cover the insurance account in the event its obligations exceed its revenues. The Law exempts contributors from paying any taxes or fees on contributions, as well as exempting forms and other official papers of the Stamp Tax normally due. It is worth mentioning that in spite of statements by officials made earlier this year that claimed the State had allocated EGP 5 billion from the public budget for health insurance for farmers, the actual budget announcement made no mention whatsoever of this, which raises some doubts about the possibility of the new system having the necessary funds to provide basic services. It is noteworthy that Article 18 of the Egyptian Constitution requires the State to establish a comprehensive health insurance system for all Egyptians that covers all diseases. Interestingly, the Law was passed after omitting a provision in the draft law which required the State to bear the cost difference for health services that are not covered in full by the Health Insurance Law for Farmers, such as liver transplants and other chronic diseases, and in spite of the constitutional provision, which provides for the exemption of individuals with low income from contributions to health insurance.
Expanding Healthcare Service without Addressing Structural Flaws
The Law assigns responsibility for the provision of health services (which are the same services covered by health insurance in the usual instances of sickness and accidents) to "The General Authority for Health Insurance," which decides whether to offer these services inside or outside of its own units. Worryingly, health services in rural areas (family health units and centres, as well as hospitals) already lack the human resources and equipment needed to adequately provide health care in rural area, despite not covering a large segment of uninsured farmers. This raises questions as to how healthcare providers will be able to cope with greater numbers without the structural changes required to make the system efficient. The Law requires the Prime Minister to issue the Executive Regulations of this Law within thirty days of its enactment on September 18, 2014. The Regulations are expected to address various matters including the method of subscription to the insurance service, the method of collection of contributions, and whether there will be separate accounts for farmers and agricultural workers at the General Authority for Health Insurance.   [1] Presidential Decree-Law No.127/2014 regulating the health insurance for farmers and agriculture workers, Official Gazette, Issue No. 37 (bis) (c), 17 September 2014.
On the occasion of Farmer’s Day, 9 September 2014, Presidential Decree-Law 127 of 2014 was issued regulating the health insurance for farmers and agriculture workers (the "Law"),[1] whereby the State will provide health insurance for agriculture workers and farmers who do not have any insurance under any other decree. The Law has defined ‘farmer’ as "any person engaged in the activity of agriculture and for whom agriculture represents the main source of income". The term ‘agriculture worker’ was not defined.
Funding the Insurance
Article 4 of the Law addresses the ways in which the new insurance system will be financed; these include annual subscriptions paid by the beneficiary of the insurance up to a maximum of EGP 120 per annum, an annual subscription borne by the public purse of EGP 200, a Ministry of Agriculture contribution in the amount of 2% of charges for services provided by the Ministry, as well as the financial support provided by agriculture entities and other grants and donations provided by other associations. The financing proceeds will be deposited in a special account with the General Authority for Health Insurance, to be supervised by the Central Accounting Agency and actuarially evaluated once every three years. The Law obliges the State Treasury to cover the insurance account in the event its obligations exceed its revenues. The Law exempts contributors from paying any taxes or fees on contributions, as well as exempting forms and other official papers of the Stamp Tax normally due. It is worth mentioning that in spite of statements by officials made earlier this year that claimed the State had allocated EGP 5 billion from the public budget for health insurance for farmers, the actual budget announcement made no mention whatsoever of this, which raises some doubts about the possibility of the new system having the necessary funds to provide basic services. It is noteworthy that Article 18 of the Egyptian Constitution requires the State to establish a comprehensive health insurance system for all Egyptians that covers all diseases. Interestingly, the Law was passed after omitting a provision in the draft law which required the State to bear the cost difference for health services that are not covered in full by the Health Insurance Law for Farmers, such as liver transplants and other chronic diseases, and in spite of the constitutional provision, which provides for the exemption of individuals with low income from contributions to health insurance.
Expanding Healthcare Service without Addressing Structural Flaws
The Law assigns responsibility for the provision of health services (which are the same services covered by health insurance in the usual instances of sickness and accidents) to "The General Authority for Health Insurance," which decides whether to offer these services inside or outside of its own units. Worryingly, health services in rural areas (family health units and centres, as well as hospitals) already lack the human resources and equipment needed to adequately provide health care in rural area, despite not covering a large segment of uninsured farmers. This raises questions as to how healthcare providers will be able to cope with greater numbers without the structural changes required to make the system efficient. The Law requires the Prime Minister to issue the Executive Regulations of this Law within thirty days of its enactment on September 18, 2014. The Regulations are expected to address various matters including the method of subscription to the insurance service, the method of collection of contributions, and whether there will be separate accounts for farmers and agricultural workers at the General Authority for Health Insurance.   [1] Presidential Decree-Law No.127/2014 regulating the health insurance for farmers and agriculture workers, Official Gazette, Issue No. 37 (bis) (c), 17 September 2014.